Drug General Information (ID: DDIYPAMSFR)
Drug Name			Diclofenamide		Drug Info		Digitoxin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Ophthalmic Glaucoma Agents				Antiarrhythmic Agents
Structure

Mechanism of Diclofenamide-Digitoxin Interaction (Severity Level: Moderate)
Increased risk of hypokalemia Click to Show/Hide Mechanism Graph
Drug Name		Diclofenamide				Digitoxin
Mechanism 1		Hypokalemia				Hypokalemia
Key Mechanism Factor 1
		Factor Name		Hypokalemia
		Factor Description		Hypokalemia is a condition in which the amount of potassium in your blood is lower than normal. If you are mildly hypokalemic, you may not have any signs or symptoms, but severe hypokalemia may have the following symptoms: fatigue, constipation, frequent or heavy urination, muscle cramps or skin tingling, muscle weakness, and a fast or irregular heartbeat.
Mechanism Description		Increased risk of hypokalemia by the combination of Diclofenamide and Digitoxin
Increased risk of hypomagnesemia Click to Show/Hide Mechanism Graph
Drug Name		Diclofenamide				Digitoxin
Mechanism 2		Hypomagnesemia				Hypomagnesemia
Key Mechanism Factor 2
		Factor Name		Hypomagnesemia
		Factor Description		Hypomagnesemia is a condition that occurs when you have too much magnesium in your body. Symptoms of hypomagnesemia include: nausea, vomiting, neurological damage, abnormally low blood pressure (hypotension), flushing, and headaches.
Mechanism Description		Increased risk of hypomagnesemia by the combination of Diclofenamide and Digitoxin

Recommended Action
Management		Digoxin, potassium and magnesium levels should be followed closely. Hypokalemia and hypomagnesemia should be treated appropriately. Digitalis dose adjustments may be required. Patients should be advised to notify their physicians if they experience signs of possible digoxin toxicity or electrolyte disturbances, such as weakness, lethargy, muscle pains or cramps, nausea, anorexia, visual disturbances, or irregular heartbeats.

References
1	Semple P, Tilstone WJ, Lawson DH "Furosemide and urinary digoxin clearance." N Engl J Med 293 (1975): 612-3. [PMID: 902451]
2	Tilstone WJ, Semple PF, Lawson DH, Boyle JA "Effects of furosemide on glomerular filtration rate and clearance of practolol, digoxin, cephaloridine, and gentamicin." Clin Pharmacol Ther 22 (1977): 389-94. [PMID: 902451]
3	Whang R, Oei TO, Watanabe A "Frequency of hypomagnesemia in hospitalized patients receiving digitalis." Arch Intern Med 145 (1985): 655-6. [PMID: 3985729]